Level or not? Comparing general practice in areas of high and low socioeconomic deprivation in England

Level or not? Comparing general practice in areas of high and low socioeconomic deprivation in England
Health Foundation September 2020 https://doi.org/10.37829/HF-2020-RC13

• This briefing seeks to explore the extent to which the inverse care law, as defined by the British GP Julian Tudor Hart, still applies to general practice in England nearly 50 years on from its first description.

An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York City

An ecological study of socioeconomic predictors in detection of COVID-19 cases across neighborhoods in New York City [Preprint*]
MedRxiv 22 April 2020
doi: https://doi.org/10.1101/2020.04.17.20069823

• Investigated whether potential socioeconomic factors can explain between-neighbourhood variation in the number of detected COVID19 cases. 
• These findings indicate associations between neighbourhoods with a large dependent population, those with a high proportion of males, and low-income neighbourhoods and detected COVID-19 cases. Given the elevated mortality in aging populations, the study highlights the importance of public health management during and after the current COVID-19 pandemic. Further work is warranted to fully understand the mechanisms by which these factors may have affected the number of detected cases, either in terms of the true number of cases or access to testing.
• *Preprint - not peer reviewed

Index of Multiple Deprivation - PHE tool

Index of Multiple Deprivation - PHE tool
PHE v1.4 Feb 2020

• A visualisation tool (Microsoft Power BI) which allows users to see scores and rank for IMD and its domains across a range of different geographies, 

In deprived areas, patients referred for psychological therapy are less likely to receive treatment

In deprived areas, patients referred for psychological therapy are less likely to receive treatment [Infographic]
Health Foundation January 2020

• Analysis of publicly available data indicates that referrals to IAPT services from patients in deprived areas are less likely to receive a course of treatment than those in wealthier areas.

How have inequalities in the quality of care changed over the last 10 years

How have inequalities in the quality of care changed over the last 10 years
QualityWatch 23 January 2020

• Analysis of data for 23 indicators of quality of NHS care has shown that people living in the most deprived areas of England experience a worse quality of NHS care and poorer health outcomes than people living in the least deprived areas. 
• The authors used Hospital Episode Statistics, patient survey data, published health statistics and the Index of Multiple Deprivation. Using this data they looked at 23 indicators measuring the quality of NHS care for the 10% of people living in the most deprived areas and the 10% of people living in the least deprived areas of England. From this they constructed an inequality score that is comparable across different performance measures and over time.

Using Hierarchical Clustering to Explore Patterns of Deprivation Among English Local Authorities

Using Hierarchical Clustering to Explore Patterns of Deprivation Among English Local Authorities
J Public Health (Oxf) 28 Dec 2019 ;fdz182. doi: 10.1093/pubmed/fdz182

• Hierarchical agglomerative (i.e. bottom-up) clustering methods were applied to domain scores for 152 upper tier local authorities. Five distinct clusters that do not correspond closely to quintiles of deprivation were identified. This approach may help to distinguish between places that face similar underlying challenges, and places that appear similar in terms of overall deprivation scores, but that face different challenges.

Abstract

Premature mortality attributable to socioeconomic inequality in England between 2003 and 2018

Premature mortality attributable to socioeconomic inequality in England between 2003 and 2018: an observational study
The Lancet December 05, 2019 DOI:https://doi.org/10.1016/S2468-2667(19)30219-1

• A cross-sectional study of 2·5 million premature deaths in England (2003-2018) found that one in three was attributable to neighbourhood deprivation measured by upstream determinants of health including income, employment, education, and crime.The biggest contributors were ischaemic heart disease , respiratory cancers and chronic obstructive pulmonary disease.
• See the tableaux map to explore the data at LA level. 
• Data available here.

Joint contribution of socioeconomic circumstances and ethnic group to variations in preterm birth, neonatal mortality and infant mortality in England and Wales

Joint contribution of socioeconomic circumstances and ethnic group to variations in preterm birth, neonatal mortality and infant mortality in England and Wales: a population-based retrospective cohort study using routine data from 2006 to 2012
BMJ Open. 31 July 2019; 9(7): e028227. doi: 10.1136/bmjopen-2018-028227

• An exploration of the variation in risks of adverse birth outcomes across ethnic groups and socioeconomic circumstances across England and Wales concludes that up to a third of the variance in birth outcomes across ethnic groups was attributable to differences in IMD, and there was strong statistical evidence of an indirect effect through IMD in the effect of ethnicity on birth outcomes.

Abstract